Bariatric surgery reduces mortality of obese elderly by 60%, says study

A study carried out in the United States shows benefits of bariatric surgery in obese people with comorbidities and for the elderly over 65 years. Among the groups studied, the risk of mortality from heart health-related events was reduced by up to 60%.

In Brazil, bariatric surgery, which aims to reduce the size of the stomach, is recommended for people with a BMI (body mass index, measured by dividing weight by height squared) greater than 35 from 16 years old. According to data from the Ministry of Health, between 2006 and 2019 the number of obese elderly people increased from 16.1% to 23%.

The intervention reduces the risk of cardiovascular events by improving the control of different cardiac risk factors, such as diabetes, hyperlipidemia, hypertension and sleep-disordered breathing, in addition to being related to a lower risk of mortality from different types of cancer.

The analysis was based on the follow-up of 189,770 people enrolled in Medicare, the American health insurance, who have limiting comorbidities or who are over 65 years old, for four consecutive years, between 2013 and 2019. Participants were divided equally into two groups. , one with those who underwent surgery and another, control, with obese patients who did not adhere to the intervention.

The results, which were published in the Journal of the American College of Cardiology, show that obese people who underwent the procedure had a 37% drop in mortality, 54% in heart failure, 37% in heart attacks and 29% in cases of stroke. brain).

As for the elderly over 65, who represented 33% of the study participants, the overall results were even more expressive: 60% reduction in the risk of all-cause mortality, 79% lower risk of hospitalization for heart failure, 80 % lower risk of heart attack, but no difference in stroke risk.

“What stands out in the research is that the control and surgery groups were very evenly divided. Both had people with hypertension (80% in one group and 78% in the other), uncomplicated diabetes (32% and 31 %) and obstructive pulmonary disease (11% of people in both groups), which makes the comparison more accurate”, says Caetano Marchesini, bariatric and metabolic surgeon at Hospital Marcelino Champagnat, in Curitiba, Paraná.

According to data from the IFSP (International Federation for the Surgery of Obesity and Metabolic Disorders, in Portuguese), this type of surgery is still performed in less than 1% of eligible patients.

“There are several causes for this, including misinformation, fear and prejudice with the surgery. Many patients think they are too old. Others think it doesn’t work, because some patients actually gain weight again because of their habits, but the results of this study show that, in addition to the low risk, the benefits outweigh these risks”, points out Marchesini.